The picture painted by a report from the Center for American Progress released Wednesday is a gloomy one.

Here's how costs have grown in some key categories:Health carePremiums and deductibles are higher than they were about a decade ago. And more people are paying them. Average out-of-pocket health care costs for a family of four with an employer-provided health plan jumped 85 percent to $8,600 a year from 2002 to 2012, according to the CAP report. The figures are adjusted for inflation and are for preferred-provider organization plans, which restrict coverage to certain doctors.Only half of Americans who obtained health care coverage through their jobs had faced deductibles in 2002, according to the nonprofit National Institute for Health Care Management. By 2011, that figure had reached three-quarters.Americans must channel more of their take-home pay to medical care: Health care spending in the United States rose from an average of 5.4 percent of all spending in 2000 to 7.1 percent in 2013, according to Labor Department data. The increase from 1989 to 2000 was much smaller: From 5.1 percent to 5.4 percent.Higher educationThe average amount a middle-class family with two kids must save for college education even after you include grants and other aid jumped 39 percent from 2000 to 2012 to $5,300, the center's study says. That's based on costs for four-year public colleges. Tuition and fees at those institutions soared 86 percent, adjusted for inflation, from 2000 to 2012. That was much sharper than the 52 percent rise in the preceding 12 years, according to data from the College Board.One reason those costs have skyrocketed is that state aid to higher education has tumbled 24 percent in the past decade on a per-student basis, the College Board says. That's forced students to bear more of the cost.Child careChild care costs for a family of four have soared an average of 37 percent in the past 12 years and now exceed the typical cost of renting a home in every state. Census data point to a long-term trend: Average weekly child care costs for families with working mothers, adjusted for inflation, jumped from $84 in 1985 to $143 in 2011.HousingFor the typical four-member family, housing costs have jumped 28 percent in the past 12 years, the center's report finds. That partly reflects higher home prices, which have rebounded sharply since the Great Recession. As a result, the number of new mortgages issued fell to a 17-year low this spring.Renters also face higher costs. More than half of renters spend more than 30 percent of their income on housing the level above which the government considers housing to be unaffordable.Less savingThose trends have made it harder for middle-class families to save and build wealth.For families in the middle 20 percent of incomes, median net worth fell 17 percent to $55,400 in 2013 from $66,600 in 2010, according to the Federal Reserve's latest Survey of Consumer Finances. Net worth equals the value of homes, savings, investments and other assets minus mortgages, credit card and other debts.Associated Press